Community-based approach to schistosomiasis control
Community-based approach to schistosomiasis control
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DOI：
10.1016/0001-706x(95)00118-x
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发表时间：
1996-04-01
期刊：
影响因子：
2.7
通讯作者：
Hewlett, BS
中科院分区：
文献类型：
--
作者：
Cline, BL;Hewlett, BS
除了少数例外，控制血吸虫病的努力一直依赖于与“外来者”的持续社区合作，而不是在社区内建立能力和手段，在最低限度的外部支持下执行持续的疾病控制措施。喀麦隆极北省Kaele分区的一个方案是一个有用的模式，该方案旨在建立初级保健系统并将其纳入该地区高流行的泌尿血吸虫病控制。在社区一级，在尽量不依赖外部资源的情况下，开展了文化上适当和有效的卫生教育，建立了诊断和治疗血吸虫病的能力，提供了方便和低成本的诊断和药物治疗（吡喹酮），并在非常有限的基础上控制了蜗牛。已作出努力，在现有社区结构和机构的基础上加以发展和加强，而不是建立新的结构和机构。干预措施的影响是衡量在知识和行为，感染的流行和强度，利用卫生服务，并在一个普遍的成本回收系统的背景下，资助控制活动的能力方面的变化。讨论了方案的成功和失败，以及吸取的教训及其影响。
With few exceptions, efforts to control schistosomiasis have relied upon ongoing community cooperation with 'outsiders' rather than creating within the community the capacity and means for carrying out ongoing disease control measures with minimal external support. Offered as a useful model is a program in Kaele subdivision, Extreme North Province, Cameroon designed to establish and integrate within the primary health care (PHC) system the control of urinary schistosomiasis, hyperendemic in the region. At the community level, and with minimal dependence upon external resources, culturally appropriate and effective health education was instituted, the capacity to diagnose and treat schistosomiasis was created, diagnosis and drug therapy (praziquantel) was made available conveniently and at low cost, and, on a very limited basis, snails were controlled. Efforts were made to build upon and strengthen existing community structures and institutions rather than create new ones. The impact of the interventions was measured in terms of changes in knowledge and behavior, prevalence and intensity of infection, utilization of health services, and the ability to finance the control activities within the context of a generalized cost recovery system. Program successes and failures are discussed, as well as lessons learned and their implications.